| NPI | 1528115060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY WALKER Clinical Counselor 847-209-0631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180006105) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2020-08-22 |